Cardiovascular

The nurse is teaching the patient who has been prescribed propranolol. Which statement by the patient indicates an understanding of the teaching?

The patient presents to the emergency department (ED) stating, “I started getting this terrible pressure in my chest after mowing the lawn. I just know I’m having a heart attack.” Following testing, the patient is diagnosed with angina pectoris. The patient asks, “If I didn’t have a heart attack, why did I have such bad chest pain?” Which response is appropriate?

Which condition is characterized by irreversible damage to cardiomyocytes due to prolonged ischemia?

The patient presents to the emergency room (ER) after having a fever for three days and new onset severe chest pain behind the sternum. The patient asks, “What is wrong with me? Do I have pneumonia? It hurts when I breathe.” Upon assessment, the nurse notes a heart rate of 124 bpm, temperature of 37.9°C, and an intermittent friction rub upon auscultation. The lungs are clear. The nurse suspects further testing will lead to a diagnosis of which condition?

The nurse assists with a pericardiocentesis to drain a pericardial effusion and notes serosanguinous fluid. The nurse suspects which condition?

The nurse is aware prompt treatment for a pericardial effusion is necessary to prevent which life-threatening condition?

Which statement is true regarding the patient’s dilated cardiomyopathy?

The patient with mitral valve stenosis is at risk for hypertrophy of which chamber of the heart?

The patient presents to the emergency department (ED) complaining of sudden dyspnea while sleeping, dyspnea on exertion, frequent respiratory infections, and hemoptysis. The patient is also diagnosed with pulmonary hypertension. Which cardiac lesion is responsible for these symptoms?

The patient presents to the emergency department (ED) with nausea, vomiting, fever, severe knee and wrist pain, nosebleed, and lymphadenopathy. A new murmur is noted, as well. The nurse asks the patient about a recent history of which infection?

Which neurologic alteration is associated with acute rheumatic fever?

The nurse receives report on four patients at the start of the shift. Which patient does the nurse visit first?

Which urinalysis findings support the diagnosis of shock in the hypotensive patient? Select all that apply.

Which information does the nurse include in patient teaching about cholesterol testing? Select all that apply.

The child suffered a radial fracture that has just been immobilized with a plaster cast. Which action by the nurse is appropriate? 

Which medication is a beta blocker?

The 35-year-old woman is interested in starting hormonal birth control. Which characteristic, if found in the patient's medical record, indicates the patient requires an alternative form of contraceptive?

Prior to initiating routine hemodialysis for the patient with end stage renal disease (ESRD), which assessments does the nurse perform? Select all that apply.

Hemolytic anemia can have which etiologies? Select all that apply.

The patient with a lung mass that was discovered on imaging is scheduled for a flexible bronchoscopy. Which nursing action is appropriate to prepare the patient for the procedure?

The nurse notices that the patient’s peripheral IV insertion site is red and indurated. What action does the nurse perform first?

The nurse receives shift report on four patients. Which patient does the nurse see first?

The patient with a severe peanut allergy was inadvertently exposed to peanuts at work. Dyspnea persists despite the patient using the epinephrine autoinjector and emergency medical services was contacted. Which concentration of epinephrine does the first responder prepare for intramuscular injection?

The nurse assesses the cuff pressure of the patient's tracheostomy. Which cuff pressure prompts the nurse to document the finding and proceed with the assessment?

Which symptoms, if present in the patient receiving a blood transfusion, indicate the patient is experiencing an acute hemolytic transfusion reaction? Select all that apply.

Which is the most common symptom of the child with bronchiectasis?

Which lab result is expected in the patient with acute disseminated intravascular coagulation (DIC)?

A patient with signs and symptoms of cardiac chest pain arrives in the ED. Which ECG rhythm is most worrisome and requires emergent intervention?

The female patient’s hypertension is controlled with reduced sodium intake and enalapril and has no other health problems. Abdominal weight gain is noted at the patient’s regular checkup and a human chorionic gonadotropin test is positive. Further testing reveals the patient is 32 weeks pregnant. Which assessment is most important for the safety of the fetus in relation to the enalapril?

The patient has been prescribed enalapril and spironolactone for the treatment of hypertension. The nurse is providing medication education to the patient regarding diet. Which food, if selected by the patient, indicates a need for further teaching?

The nurse is teaching a community health promotion class for older adults and includes a discussion on modifying which risks for hypertension?

The nurse is completing discharge education with the parents of a child with congenital heart disease. Which statement by the mother indicates a need for further teaching?

The nurse prepares the nursing student for the administration of which short-acting cardiovascular drug that can be used to help maintain the patient’s ventricular function after cardiac surgery?

The nurse anticipates administering which medications to the patient with meningitis? Select all that apply.

The nurse is caring for a patient on the night shift in respiratory distress due to influenza. Over the last few hours, the patient has become increasingly confused, perfusion has decreased, and urine output has fallen to zero. The nurse contacts the resident physician to come assess the patient and requests an order for transfer to the intensive care unit. The physician orders the nurse to administer 1L 0.9% NaCl via IV infusion. One hour after the infusion is complete, the patient has made no improvement. What is the nurse’s next action?

The patient receiving patient-controlled analgesia (PCA) with morphine is found to be sleeping deeply and minimally responsive. Which action does the nurse take first?

The LPN/LVN informs the supervising RN, “I didn’t realize until after administering the medication, but I was supposed to give the patient a half tablet of levothyroxine; I gave him a whole tablet.” Which action does the nurse take first?

The patient intubated in the intensive care unit has the following arterial blood gas results: pH 7.21 PCO2 51 PaO2 38 HCO3 16 Base Excess -7 Which action does the nurse take first?

The 56-year-old intubated and sedated patient’s arterial blood gas results are as follows: pH = 7.25, PCO2 = 36, PaO2 = 50, HCO3- = 15, SaO2 = 86%. Other lab values are notable for a hemoglobin of 7.9 mg/dL, albumin of 2.5 g/dL, sodium of 152 mEq/L, potassium of 2.1 mEq/L, chloride of 118 mEq/L. Vital signs are notable for a heart rate of 118 bpm, blood pressure of 86/38 mmHg, temperature of 102°F, and pulse oximetry of 85% on room air. The nurse advocates for which order?

The 3.2 kg patient with persistent pulmonary hypertension of the newborn (PPHN) has the following order: Infuse norepinephrine 0.05 mcg/kg/min IV and titrate q15 minutes by 0.05 mcg/kg/min to maintain mean arterial pressure between 45 and 55 mm Hg. Overnight, the norepinephrine had been titrated to 0.25 mcg/kg/min for persistent hypotension. At 0900, the MAP rose to 62 mm Hg and the nurse decreased the infusion from 0.25 mcg/kg/min to 0.20 mcg/kg/min. At 0905, the patient’s blood pressure fell to 42 mm Hg. Which action does the nurse take first?

The patient has experienced an extravasation of norepinephrine in the right forearm. It is cool to the touch, firm, and pale. Distal to peripheral pulses are not well felt and the fingertips are dusky. Which order does the nurse clarify with the provider?

The nurse assesses the peripheral IV site of the patient who is receiving norepinephrine, which was started for profound, life-threatening hypotension and finds the hand to be firm to the touch, cool, and pale. Which action does the nurse take?

The patient has pulmonary artery hypertension. The nurse most anticipates hypertrophy of which cardiac structure will be seen on chest x-ray?

Which patient does the nurse assess first?

A patient’s central line appears occluded. Which method does the nurse use to determine if the catheter occlusion is internal?

A patient with gram-negative sepsis is in the ICU after cardiac arrest. He requires a vasopressor for severe hypotension. Which patient characteristic would prompt the nurse to hold the infusion and contact the provider?

The patient with congestive heart failure in the cardiac intensive care unit (CICU) is ordered to receive IV furosemide once per day. The lab just called and reported the patient’s serum potassium is 2.9 mEq/L. The next dose of furosemide is due now. Which is the appropriate nursing action?

The patient with chronic obstructive pulmonary disease (COPD) is brought to the post-anesthesia care unit (PACU) after abdominal surgery. Which symptom alerts the nurse to an impending complication?

The nurse is caring for a patient with pneumonia and fulminant pulmonary arterial hypertension. The patient is intubated and mechanically ventilated receiving inhaled nitric oxide (iNO). Additionally, the patient has a central line with multiple continuous infusions, including norepinephrine, vecuronium, morphine, and propofol. During the shift, the nurse begins to have difficulty breathing, a dry throat, syncope, and chest pain. Which action does the nurse take first?

The patient receiving inhaled nitric oxide (iNO) is at risk for which adverse event?